Neuromodulation : journal of the International Neuromodulation Society
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Some patients with spasticity and pain in the extremities fail to respond to increases in the dose of intrathecally delivered baclofen. ⋯ We suggest that in patients who experience symptom aggravation at increased ITB doses, potential causative factors and ITB system malfunction should first be ruled out, and consideration should then be given to decreasing the ITB dose.
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Comparative Study
Peripheral nerve field stimulation in the treatment of postlaminectomy syndrome after multilevel spinal surgeries.
Chronic low back pain in patients with postlaminectomy syndrome (PLS) is challenging to treat, especially for patients who have undergone multilevel surgical procedures. Despite conservative therapy and available interventional pain procedures including spinal cord stimulation (SCS) and intrathecal therapies, patients may continue with intractable low back pain. Peripheral nerve field stimulation (PNFS) may represent an effective alternative treatment option for these patients when conventional treatments do not provide adequate relief of intractable low back pain. ⋯ PNFS may be more effective in treating intractable low back pain than SCS in patients with PLS after multilevel spinal surgeries.
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Case Reports Randomized Controlled Trial
Deep brain stimulation for early-stage Parkinson's disease: an illustrative case.
Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective intervention in advanced Parkinson's disease (PD), but its efficacy and safety in early PD are unknown. We are conducting a randomized pilot trial investigating DBS in early PD. This report describes one participant who received bilateral STN-DBS. ⋯ This report details the first successful application of bilateral STN-DBS for early-stage PD during a clinical trial.
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Clinical Trial
Prospective analysis of the trial period for spinal cord stimulation treatment for chronic pain.
To determine patient preferences regarding the duration of trial period. ⋯ In this study, all patients could make a decision in 15 days, with successful trials requiring a shorter duration. The conversion rate was similar to rates in literature despite patients making a decision without physician input.